Provider Demographics
NPI:1356131635
Name:BEVINS, COLBY MICHAEL (FP-C, NREMT-P)
Entity type:Individual
Prefix:
First Name:COLBY
Middle Name:MICHAEL
Last Name:BEVINS
Suffix:
Gender:
Credentials:FP-C, NREMT-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 24TH ST
Mailing Address - Street 2:
Mailing Address - City:RAINELLE
Mailing Address - State:WV
Mailing Address - Zip Code:25962-1466
Mailing Address - Country:US
Mailing Address - Phone:304-661-0732
Mailing Address - Fax:
Practice Address - Street 1:257 THIRD ST
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-5925
Practice Address - Country:US
Practice Address - Phone:304-645-2252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV083336146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic